MCDH Votes to but Parcel Tax on June Ballot!

Editorial by Marianne McGee, MA/ABS

The Mendocino Coast District Hospital (MCDH) Board of Directors voted unanimously to submit a $144 Parcel Tax to voters on the June 2018 ballot, so if it passes, the money will be available in January 2019.

The Board members had a number of remarks prior to citizen input. Dr. Lucas Campos gave a reasonably clear explanation of the complex hospital financial situation, aided by a cogent handout provided by Interim CFO John Parigi. Dr. Peter Glusker brought up the “elephants in the room” expressing concerns that only 22% of survey respondents thought the management was effective, the need for the long overdue CEO performance evaluation and the need to be very clear about how the money will be spent. Dr. Kevin Miller, admitting his own lack of experience, told the audience that we need to trust the processes and volunteers, warning them to “not to listen to the wrong people” who he judges as having “axes to grind”. Kitty Bruning did not speak except to second the parcel tax motion. Chair Steve Lund facilitated the discussion, clarifying the process and promising that plans for the parcel tax income will be forthcoming.

I was surprised at the lack of citizen input and involvement when their opportunity arrived. Several Friends of the Hospital (FOH) gave feedback to assist in clarifying the proposal including how older people can defer their taxes, the need for concrete plans and the need to clarify the misleading information regarding 911. A number of us gave our input at the Planning & Finance Committees, which you can read and watch on those Mendocino TV posts.

One very angry citizen was Alan Stein, who spoke during public comments as well, citing direct issues with patient complaint unresolved by CEO Edwards as well as parcel tax concerns and management issues resulting in financial deficits. He was also upset about the CEO salary of $320,000 and a doctor earning $700,000, issues that have many people concerned. John Kermen, D.O., Chief of Staff and Anesthesiologist stated it was his contract (I had heard his was $900,000) and he supports three people. He also claimed that to replace him would cost substantially more, although the tired refrain regarding people making less money here than elsewhere is as old as the perennial whining about the high cost of housing. We have all made financial sacrifices to live in one of the most beautiful spots on earth! Although he was not finished, Mr. Stein was declared out of time and was dismissed from the podium.

The only other person to speak was concerned that the lumber barons may fight this tax as they had done with others,, although a consultant clarified he did not think their previous legal wrangling would apply to this measure.

Mr. Lund concluded this discussion with the notion that “now is the time for the real work to begin” as an independent campaign committee must form, materials developed and community outreach conducted in a very short time frame, given their insistence of the June ballot, rather than November as many have requested. Mendocino TV will be doing further research and reports regarding the details of the Parcel Tax Measure.

Interim CFO John Parigi brought new eyes to the MCDH financial problems, as was illustrated when he requested a new Purchasing Manager contract and full time permanent position. In addition to other processes and procedures he has identified, he said MCDH is losing literally millions by lack of control and mismanagement over items such as purchasing and incorrect billing costs. When this request for a new Interim Consultant was discussed, Dr.’s Miller and Glusker were concerned about the expenses associated with this contract since again, MCDH absorbs costs including air fare, housing, food and car rental. Examples of this problem were given and Manager Nancy Schmid reinforced the idea that this position will pay for itself many times over. It passed with one abstention by Dr. Glusker.

The search for a new permanent CFO is underway and unfortunately Mr. Parigi is really here only on an interim basis. He was complimented by Chair Lund for all the work he has accomplished in a very short time frame, as it appears he has identified many fiscal issues that need to be resolved. In short, the need for fiscal responsibility and reform is critical to transparency and regaining the trust of the community.

Many taxpayers, voters and community activists have recognized the need for new effective management and leadership. While there will be a November election potentially electing a new MCDH Board majority, it is difficult to imagine new volunteers will have the skills and experience to run this extremely complex and endangered organization. The Board has fiduciary responsibilities, with the most critical being their supervision of the CEO and CFO. They have finally scheduled the CEO’s long awaited evaluation on February 27 at 5:00 pm, although it is difficult to imagine they will make the management changes many are calling for.

For the other reports, facility updates and to draw your own conclusions, watch the entire meeting at the bottom of this post.

This will be one of the most critical meetings of the year as the Board decides whether or not to submit a $144 parcel tax on the June Ballot.

While there is discord about how to address the hospital, I’m pleased to see community consensus on the concept of high quality, local care. Hospital closures and reductions in service may affect older adults disproportionately, because these adults face greater challenges obtaining transportation and traveling farther distances for health care, but there is also a strong impact on young families. Without a hospital, the Mendocino coast would not be an attractive place to retire or raise a family. The hospital represents much more than medical care — it’s about sustainability of our rural community. Without it, we’ll face a greater downward spiral. I’ve had personal experience with our hospital. I was born at MCDH. My grandmother and father died there. I was present for births of cousins. My wife had gallbladder surgery in out-patient. Like many, our experiences are mixed. When Mary needed an MRI prior to back surgery, MCDH quoted $3200. St Helena extension at Lakeport offered the same service for $445 with a far superior administrative process. I’ve also been on the fire response side, packaging and rushing patients to the hospital at times fog has prevented helicopter transport, further instilling a sense of local emergency department necessity. I’ve had friends and former schoolmates work at the hospital. Some have praised it while others have recommended going elsewhere when possible. It’s difficult to derive an overall grasp of the hospital situation from anecdotal stories. I believe the burden is on the MCDH board and executives to convince us that the proposed parcel tax assessment will translate into a top tier rural

hospital. I expect the board to research what funding it’ll take to pull off the endeavor and not simply evaluate what amount the public will support on election day. Explain the plan to me like I’m five. Money is fungible. No matter what restrictions are placed on the new tax revenue, the concern about appropriate spending will remain. The underlying concern is about trust and can’t be answered legislatively. I don’t doubt the intentions of the board to address a difficult reality most rural hospitals face today, but the path to trust is transparency. Transparency is a greater concern to me than high salaries. Diagnostic equipment is expensive. Nobody will suggest the hospital save a buck by cutting corners on equipment. I can accept the idea that in a free market hospital administrators are also expensive. However, with that expense comes a need to measure success. How do we know whether the current executives are justifying their pay? I want to see a shovel ready plan with clear milestones, not just a request for more money.